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Wang YJ, Ke M, Yan M. The ocular anterior segment examination of perinatal newborns by wide-field digital imaging system: a cross-sectional study. BMC Ophthalmol 2023; 23:411. [PMID: 37828431 PMCID: PMC10571344 DOI: 10.1186/s12886-023-03139-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023] Open
Abstract
PURPOSE The aim of this study was to evaluate and summarize the developmental rules of the ocular anterior segment of neonates by means of wild-field digital imaging system. METHODS We used the wide-field digital imaging system to sequentially capture images of the neonates' eyes within 42 days after delivery, including the ocular surface, anterior segment, and fundus. At the same time, basic information at the time of birth and examination was collected. RESULTS Among 248 newborns, 51.21% were male. Abnormalities of the anterior segment such as visualization of anterior chamber angle vessels (79.03%) and iris vessels (51.21%), iris process (42.34%), persistent pupillary membranes (19.35%), albinism, congenital cataracts, corneal leucoma, and subconjunctival hemorrhage were observed in this study. There were significant differences in the appearance of iris vessels among different sex, gestational age and birth weight, postmenstrual age and weight at the time of examination and iris color groups. The iris vessels were more visualized in males relative to females (OR = 6.313, 95% CI 2.529-15.759). The greater the postmenstrual age at the time of examination, the lower the visualization of iris vessels (OR = 0.377, 95% CI 0.247-0.575). In addition, although visualization of anterior chamber angle vessels differed within the birth gestation age and weight at examination groups, there was no significant correlation by regression analysis. CONCLUSIONS The anterior segment of perinatal neonates can be visualized by the wide-field digital imaging system. The neonatal iris and anterior chamber angle are immature, and the visible vessels at the anterior chamber angle that vanish later than the surface of the iris are characteristic structures.
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Affiliation(s)
- Yu-Jing Wang
- Dept of ophthalmology, Zhongnan Hospital of Wuhan University, 430060, Wuhan, Hubei Province, P. R. China
| | - Min Ke
- Dept of ophthalmology, Zhongnan Hospital of Wuhan University, 430060, Wuhan, Hubei Province, P. R. China
| | - Ming Yan
- Dept of ophthalmology, Zhongnan Hospital of Wuhan University, 430060, Wuhan, Hubei Province, P. R. China.
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Matthaei M, Zwingelberg S, Siebelmann S, Howaldt A, Mestanoglu M, Schlereth SL, Giezelt C, Dötsch J, Fricke J, Neugebauer A, Lappas A, Dietlein T, Roters S, Bachmann BO, Cursiefen C. [Diagnostics, clinical aspects and genetics of congenital corneal opacities]. Ophthalmologe 2022; 119:443-452. [PMID: 35244750 DOI: 10.1007/s00347-022-01587-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Congenital corneal opacities are comparatively rare diseases with high amblyogenic potential. PURPOSE The present work provides an overview of the diagnostics, clinical aspects and genetics of congenital corneal opacities. METHODS A literature search was carried out to compile an overview and illustration with own clinical case examples. RESULTS Differentiated diagnostics are of high importance in the treatment of patients with congenital corneal opacities. A close cooperation between the medical departments involved and also the parents is absolutely essential. The structured classification of congenital corneal opacities provides the basis for a targeted treatment. DISCUSSION The causes and the clinical symptoms of congenital corneal opacities are manifold. The correct diagnosis should be made early and in an interdisciplinary manner. Based on this, conservative and surgical treatment measures can be planned and an impending development of amblyopia can be specifically counteracted.
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Affiliation(s)
- M Matthaei
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - S Zwingelberg
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - S Siebelmann
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - A Howaldt
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - M Mestanoglu
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - S L Schlereth
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - C Giezelt
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - J Dötsch
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland
| | - J Fricke
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland
| | - A Neugebauer
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland
| | - A Lappas
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland
| | - T Dietlein
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - S Roters
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - B O Bachmann
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland
| | - C Cursiefen
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland.,Zentrum für Molekulare Medizin Köln (ZMMK), Universität zu Köln, Köln, Deutschland
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Pujari A, Agarwal D, Chawla R, Kumar A, Sharma N. Intraoperative Optical Coherence Tomography Guided Ocular Surgeries: Critical Analysis of Clinical Role and Future Perspectives. Clin Ophthalmol 2020; 14:2427-2440. [PMID: 32904675 PMCID: PMC7457570 DOI: 10.2147/opth.s270708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 08/07/2020] [Indexed: 11/23/2022] Open
Abstract
Intraoperative imaging of ocular tissues for diagnostic and therapeutic applications has gained immense admiration in recent years. The real time cross-sectional imaging, as well as three and four dimensional reconstruction abilities of intraoperative optical coherence tomography (iOCT), has enhanced our knowledge on many fronts in surgical maneuvers. In this review, we discuss the iOCT discovered constructive knowledge in the cornea, cataract, refractive, glaucoma, pediatric ocular, and various retinal conditions. The practical utility with decision modifying aspects along the specified ocular tissues and with respect to specific ocular entities have been narrated. Moreover, limitations and future directions have also been emphasized to make ophthalmic care more comprehensive in the future.
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Affiliation(s)
- Amar Pujari
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Divya Agarwal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohan Chawla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Siebelmann S, Horstmann J, Scholz P, Bachmann B, Matthaei M, Hermann M, Cursiefen C. Intraoperative changes in corneal structure during excimer laser phototherapeutic keratectomy (PTK) assessed by intraoperative optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2018; 256:575-581. [PMID: 29302786 DOI: 10.1007/s00417-017-3867-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 11/21/2017] [Accepted: 12/11/2017] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Excimer laser phototherapeutic keratectomy (PTK) is a safe treatment for superficial corneal opacities, e.g., in corneal dystrophies or degenerations. Nevertheless, no standardized treatment protocols are available and intraoperative monitoring was not possible, so far. Here we evaluate the potential benefits of the intraoperative assessment by microscope-integrated intraoperative optical coherence tomography (MI-OCT) of corneal optical properties during PTK. METHODS Retrospective study of eight patients (one male, seven females; age range, 43-80 years, mean = 66.1 years) using an 840-nm microscope-integrated spectral-domain OCT (iOCT; OptoMedical Technologies, Luebeck, Germany adapted to HS Hi-R Neo 900A, Haag Streit Surgical, Wedel, Germany). Images were acquired before and after corneal abrasion and after PTK. For PTK, a SCHWIND Amaris 750S excimer laser (SCHWIND eye-tech-solutions GmbH und KO. KG) was used. Parameters assessed were the central corneal thickness (CCT), changes in central depth-dependent corneal tissue intensity (TI), and corneal surface roughness (SR) in cross-sectional images of the cornea. RESULTS Intraoperative monitoring using microscope-integrated OCT was possible in all patients at all time points. TI of the anterior corneal stroma decreased significantly (p = 0.037) after PTK (T1 = 15.1 ± 3.6, T2 = 15.0 ± 3.84, T3 = 13.7 ± 3.38), but not after corneal abrasion alone, indicating increased transparency caused by excimer laser PTK. CCT was significantly lower after corneal abrasion (p = 0.017), but not after PTK (T1 = 630.4 ± 70 μm, T2 = 544.1 ± 59.4 μm, T3 = 558.3 ± 52.5 μm. SR significantly decreased (p = 0.043) after PTK (T1 = 614.4 ± 37.5 pixels, T2 = 634.4 ± 35.6 pixels, T3 = 611.0 ± 40.3 pixels). CONCLUSIONS Intraoperative OCT allows real-time imaging during PTK and the assessment of corneal optical transparency and its surface roughness. It has to be clarified in larger studies if these parameters correlate with later postoperative visual outcomes.
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Affiliation(s)
- Sebastian Siebelmann
- Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.
| | - Jens Horstmann
- Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.,Cluster of Excellence: Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany
| | - Paula Scholz
- Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
| | - Björn Bachmann
- Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
| | - Mario Matthaei
- Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
| | - Manuel Hermann
- Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
| | - Claus Cursiefen
- Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
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